A sample validation of the Adolescent Stress Questionnaire (ASQ) in New Zealand

The Adolescent Stress Questionnaire (ASQ) is a 56‐item scale measuring stress in 10 domains. The scale has been tested in a number of countries worldwide with mixed support. The current study tested the factor structure, construct validity, and reliability in a sample (n = 1,601) comprising a general population of adolescents in New Zealand. Support was found for the 10‐factor structure with adequate internal consistency as well as strong factorial invariance between male and female participants. Significant inverse correlations were found between all ASQ domains and both life satisfaction and perceived academic achievement. Most ASQ domains revealed gender differences, with female participants reporting greater stress than males. Toward a nonbinary perspective of gender, gender‐neutral participants reported greater stress than males and females in certain stress domains. Results based on regression analyses indicate that nonacademic ASQ domains were generally related to life satisfaction whereas academic ASQ domains were related to perceived academic achievement. Positive and negative interaction effects were observed between gender and ASQ domains on life satisfaction and academic achievement. Overall, the current results indicate that the ASQ appears to be a reliable, valid instrument for adolescent stress in New Zealand with relevance to perceived life satisfaction and achievement.     

中文版Braden QD压力性损伤风险评估量表在患儿中的信效度研究

目的对Braden QD压力性损伤风险评估量表进行汉化并检验其信效度。方法在获得原量表作者授权后,对原量表进行翻译、回译、检译、跨文化调适以及预调查,形成中文版Braden QD量表;采用方便抽样法选取323例住院患儿进行问卷调查,以测量量表的信度和效度。结果量表的Cronbach′sα系数为0.760,折半信度为0.820,各条目删除后新的Cronbach′sα系数均较删除前的Cronbach′sα系数低,组内相关系数为0.991(P<0.01);量表水平内容效度指数和条目水平内容效度指数均为1.000,探索性因子分析共抽取2个公因子,累积方差贡献率为63.959%,验证性因子分析结果显示模型拟合良好。结论中文版Braden QD量表经验证后具有良好的信效度,可用于我国住院患儿压力性损伤风险评估。     

Psychometric Properties of the Work Well Index: A Short Questionnaire for Work‐Related Stress

The aim of this study was to test the psychometric properties of a short questionnaire for work‐related stress entitled Work Well index (WWi) and its interaction with different variables of self‐reported health. An online survey was conducted in a sample of 1,218 employees (51% female) in four countries of an international insurance company. Internal consistency reliability, factorial validity, convergent validity and criterion validity of the 10‐item WWi were analyzed. Good internal consistency reliability of the WWi was obtained (Cronbach's α coefficient = 0.85). Confirmatory factor analysis showed a satisfactory model fit of the data (AGFI = 0.92). The WWi was highly correlated to conceptually close constructs such as demand–control, effort–reward imbalance and workplace social capital (p < 0.001). Moreover, the 10‐item WWi was significantly (p < 0.001) associated with elevated risk of self‐rated health, absenteeism, presenteeism and depression (odds ratio 1.63, 1.36, 2.08, 2.95, respectively). We conclude that this short questionnaire is a reliable and valid instrument measuring psychosocial stress at work. Copyright © 2016 John Wiley & Sons, Ltd.     

Confirmatory Factor Analysis of the Perceived Stress Scale‐4 in a Community Sample

Although the Perceived Stress Scale (PSS) is among the most widely used measures of perceived stress, it has only recently begun to be tested in independent psychometric validation studies, and the four‐item version of the PSS (PSS‐4) (the briefest version of this measure) has never undergone testing to examine and confirm the originally proposed structure. To address this paucity of research, the present study (a) tested the structure of the PSS‐4 in the first confirmatory factor analysis of the instrument and (b) tested for item‐level gender differences in the PSS that have been demonstrated in other versions of this scale. Results indicated that the PSS four‐item measure does not fit its proposed model. Additionally, score differences were observed for one item across genders. Copyright © 2014 John Wiley & Sons, Ltd.     

Measurement Invariance of the Perceived Stress Scale and Latent Mean Differences across Gender and Time

Measurement invariance of the 2‐factor model of the Perceived Stress Scale—10‐item version (Cohen & Williamson, 1988) was tested across men and women at two time points and in the combined total sample over a 2‐year time frame (n = 871). Measurement invariance results indicated that the scale measured the latent factors, stress and counter‐stress, equivalently in men and women and over time. With measurement invariance demonstrated, differences in latent means were tested. Results indicated that men had lower levels of frequencies of stressors, and at one time point, higher levels of counter‐stress, when compared with women. When examining change in frequencies of stressors and counter‐stress over 2 years with the combined male and female sample, stressors remained stable, yet counter‐stress increased over time. These findings may aid in the interpretation of results when examining stressors and counter‐stress in clinical samples where one would expect stress to increase, whereas positive psychological states decrease. Copyright © 2012 John Wiley & Sons, Ltd.     

中文版护士对老年患者活动能力低下预防性护理评价量表的信效度研究

目的汉化并检验护士对老年患者活动能力低下预防性护理评价量表的信度和效度。方法基于跨文化翻译的方法将日文版护士对老年患者活动能力低下预防性护理评价量表进行翻译、回译及文化调适后形成中文版护士对老年患者活动能力低下预防性护理评价量表,共8个维度46个条目。选取261名护士进行调查,检验中文版量表的信度和效度。结果中文版量表内容效度指数(CVI)为0.834;共析出8个公因子,总贡献率为69.049%,各条目对相应公因子的载荷值为0.516~0.795;各条目间以及与总分之间的相关系数r值为0.306~0.658,0.579~0.836(均P0.01)。总量表的Cronbach′sα系数为0.845,各维度Cronbach′sα系数为0.675~0.856;重测信度r值为0.712~0.880。结论中文版护士对老年患者活动能力低下预防性护理评价量表具有良好的信度和效度,可用于我国护士对老年患者活动能力低下实施预防性护理的能力或质量评价。     

Kihon老年衰弱筛查量表的汉化及信效度检验

目的翻译并修订Kihon老年衰弱筛查量表,对其进行信效度评价。方法遵循Brislin模式,经过翻译、回译、文化调适和预试验,确定中文版老年衰弱筛查量表条目。采用方便抽样法,对太原市6个社区458名老年人进行调查,评价信效度。结果总量表Cronbach′sα系数为0.882,各维度系数为0.733~0.856;总量表重测信度系数为0.944,各维度重测信度系数为0.902~0.979;量表总内容效度指数为0.989,各条目内容效度指数为0.857~1.000。探索性因子分析提取7个公因子累积贡献率为69.146%。验证性因子分析所构建的结构方程模型经修正后,模型拟合良好。结论中文版本Kihon老年衰弱筛查量表有良好的信效度,可作为社区老年人衰弱筛查工具。     

Development of a disease specific health related quality of life measure for adults and adolescents with cystic fibrosis

BACKGROUND: Health related quality of life (HRQoL) measurement is important in determining the impact of disease on daily functioning and subsequently informing interventions. In cystic fibrosis (CF) generic HRQoL measures have been employed but these may not be sufficiently specific. The aim of the current work was to develop and validate a disease specific HRQoL measure for adults and adolescents with cystic fibrosis. METHODS: Areas of concern to adults and adolescents with CF were identified by unstructured interviews, self-administered questionnaires, consultation with multidisciplinary specialist staff, a review of the relevant literature, and examination of other HRQoL measures. Items for the questionnaire were generated on the basis of this process. Continued evaluation and development of the Cystic Fibrosis Quality of Life (CFQoL) questionnaire was undertaken by a process of statistical analysis and continued feedback from patients. The full testing and validation of the CFQoL questionnaire took place over four phases: (1) initial item generation and testing of a preliminary questionnaire, (2) testing and validation of the second version of the questionnaire, (3) test-retest reliability of a third and final version of the questionnaire, and (4) sensitivity testing of the final version of the questionnaire. RESULTS: Nine domains of functioning were identified using principal components analysis with varimax rotation. Internal reliability of the identified domains was demonstrated using Cronbach alpha coefficients (range 0.72-0.92) and item to total domain score correlations. Concurrent validity (range r = 0.64-0.74), discriminatory ability between different levels of disease severity, sensitivity across transient changes in health (effect size range, moderate d = 0.56 to large d = 1.95), and test-retest reliability (r = 0.74-0.96) were also found to be robust. CONCLUSIONS: The CFQoL questionnaire is a fully validated disease specific measure consisting of 52 items across nine domains of functioning which have been identified by, and are of importance to, adolescents and adults with cystic fibrosis. This measure will be useful in clinical trials and longitudinal studies.     

Negative emotionality in a large community sample of adolescents: the factor structure and measurement invariance of the short version of the depression anxiety stress scales (DASS‐21)

The purpose of this study was to examine five possible models of negative emotionality using the short version of the Depression Anxiety Stress Scales (DASS) in a large sample of non‐clinical adolescents (N = 677). The results from our confirmatory factor analysis reveal that negative emotionality in adolescents is best represented by the tripartite model. Our findings are in line with other studies regarding the structure of negative emotionality in adolescents and provide support for the validity of the tripartite model of negative emotionality underlying the DASS‐21 in adolescent boys and girls. Copyright © 2010 John Wiley & Sons, Ltd.     

护士关怀行为量表的汉化及信效度分析

目的对关怀行为量表进行汉化并验证其信度和效度。方法获得原作者授权后,严格遵循国际上汉化量表的流程,翻译并回译量表。采取便利抽样法,从4所三级甲等医院抽取243名临床护士和262例患者进行问卷调查;其中有27名护士和21例患者参与重测。采用临界比值和同质性检验来验证量表条目的适切性;采用专家评议法评价量表的内容效度;通过探索性因子分析和验证性因子分析评价量表的结构效度;采用内部一致性系数、重测信度评价问卷的信度。结果所有条目的决断值12.630~22.571,各条目得分与量表总分的相关系数r值为0.643~0.811。各条目水平的内容效度(I-CVI)和量表水平的内容效度(S-CVI)均为1。122份护士问卷和131份患者问卷探索性因子分析均提取出3个公因子,累积方差贡献率分别为71.790%和64.956%,条目负荷量为0.558~0.893。验证性因子分析,结果显示,模型与护士群体的适配度基本良好,与患者群体的适配度尚可。总量表的Cronbach′sα系数为0.959,3个维度的重测信度分别为0.794、0.633、0.575。结论中文版护士关怀行为量表具有较好的信度和效度,可以作为评价我国临床护士对患者关怀程度的工具。     

General job stress: a unidimensional measure and its non-linear relations with outcome variables

This article aims to examine the non‐linear relations between a general measure of job stress [Stress in General (SIG)] and two outcome variables: intentions to quit and job satisfaction. In so doing, we also re‐examine the factor structure of the SIG and determine that, as a two‐factor scale, it obscures non‐linear relations with outcomes. Thus, in this research, we not only test for non‐linear relations between stress and outcome variables but also present an updated version of the SIG scale. Using two distinct samples of working adults (sample 1, N = 589; sample 2, N = 4322), results indicate that a more parsimonious eight‐item SIG has better model‐data fit than the 15‐item two‐factor SIG and that the eight‐item SIG has non‐linear relations with job satisfaction and intentions to quit. Specifically, the revised SIG has an inverted curvilinear J‐shaped relation with job satisfaction such that job satisfaction drops precipitously after a certain level of stress; the SIG has a J‐shaped curvilinear relation with intentions to quit such that turnover intentions increase exponentially after a certain level of stress. Copyright © 2011 John Wiley & Sons, Ltd.     

Psychometric Properties of the Catastrophic Cognitions Questionnaire‐Modified (CCQ‐Modified) Among Community Samples in Malaysia

The Catastrophic Cognitions Questionnaire‐Modified (CCQ‐M) is a common instrument for measuring catastrophic thoughts. In some countries, however, CCQ‐M still poses concerns following the lack of appropriate validation among their populations. The current study aimed to examine the factor structure of the CCQ‐M, the reliability, and the validity in community samples in Malaysia. The Malay version of CCQ‐M and additional measures assessing the symptoms and cognitions relevant to anxiety disorders were completed by 682 university students and general community. Exploratory factor analysis revealed a two‐factor structure accounting for 62.2% of the total variance. Confirmatory factor analysis confirmed the two‐factor model by deleting four items. The Cronbach's alpha coefficients for the total and the two subscales were .94, .90, and .92, respectively. Test–retest reliability analysis was conducted on 82 university students in the interval period of 14 days, and the result was r = .58. Evidence supported the concurrent, convergent, and discriminant validity. In conclusion, the 17‐item CCQ‐M‐Malaysia is a valid and reliable instrument for assessing catastrophic cognitions among Malaysian populations. Copyright © 2015 John Wiley & Sons, Ltd.     

Development of a symptom specific health status measure for patients with chronic cough: Leicester Cough Questionnaire (LCQ)

BACKGROUND: Chronic cough is a common condition which has a significant impact on quality of life. Assessment and management are hampered by the absence of well validated outcome measures. The development and validation of the Leicester Cough Questionnaire (LCQ), a self-completed health related quality of life measure of chronic cough, is presented. METHODS: Patients with chronic cough were recruited from outpatient clinics. The development of the LCQ consisted of three phases: phase 1 (item generation); phase 2 (item reduction, allocation of items to domains and validation of questionnaire); phase 3 (repeatability and responsiveness testing of final version of questionnaire). RESULTS: Phase 1: Literature review, multidisciplinary team meeting and 15 structured interviews with chronic cough patients generated 44 items (LCQ1) with a 7 point Likert response scale. Phase 2: 104 chronic cough outpatients completed the LCQ1 along with an importance rating for each item. The clinical impact factor method was used for item reduction to 19 items (LCQ2: final version). These items were divided into three domains (physical, psychological and social) following expert opinion. Internal reliability, as assessed using Cronbach's alpha coefficients, varied between 0.79 and 0.89. Concurrent validity was high when the LCQ2 (n=56) was compared with a cough visual analogue score (r=-0.72). There was a moderate relationship with response to the St George's Respiratory Questionnaire (r=-0.54) and SF36 total score (r=0.46). Phase 3: Two week repeatability (n=24) was high with intraclass correlation coefficients for domains varying between 0.88 and 0.96. Responsiveness in nine patients whose cough was successfully treated varied within domains from an effect size of 0.84 to 1.75. CONCLUSION: The LCQ is a valid, repeatable 19 item self-completed quality of life measure of chronic cough which is responsive to change. It should be a useful tool in clinical trials and longitudinal studies.     

A Parental Tool to Screen for Posttraumatic Stress in Children: First Psychometric Results

The Children's Revised Impact of Event Scale (CRIES‐13) is a brief self‐report measure designed to screen children for posttraumatic stress disorder (PTSD). This study investigates the psychometric properties of a Dutch version of the CRIES‐13–parent version and evaluates its correlation with the child version. A sample of 59 trauma‐exposed children (8 years–18 years) and their parents completed an assessment including the CRIES‐13 (child/parent version) along with the Anxiety Disorders Interview Schedule for DSM‐IV: Parent version. Results demonstrated good internal consistency (α = .87) with acceptable values for the 3 subscales. A strong correlation (r = .73) with another measure of PTSD and lower correlations with a behavioral measure (r = .15 to .38) were found, confirming the convergent/divergent validity. A cutoff score ≥ 31 emerged as the best balance between sensitivity and specificity, and correctly classified 83.6% of all children as having a diagnosis of PTSD. This study provides support for the reliability and validity of the CRIES‐13–parent version as a screening measure for posttraumatic stress in children.     

Background Stress Inventory: Developing a Measure of Understudied Stress

Background stress is an understudied source of stress that involves both ambient stress and daily hassles upon which new stressors are superimposed. To date, an accurate measure of the background stress construct has not been available. We developed the Background Stress Inventory, a 25‐item self‐report measure that asks respondents to indicate how distressed they have felt over the past month and the majority of the past year across five domains: financial, occupation, environment, health and social. Seven hundred seventy‐two participants completed the paper‐and‐pencil measure; the sample was randomly split into two separate subsamples for analyses. Exploratory factor analysis suggested five factors corresponding to these domains, and confirmatory factor analysis showed acceptable global fit (X²(255) = 456.47, comparative fit index = 0.94, root mean square error of approximation = 0.045). Cronbach's alpha (0.89) indicated good internal reliability. Construct validity analyses showed significant positive relationships with measures of perceived stressfulness (r = 0.62) and daily hassles (0.41), p's < 0.01. Depressive symptoms (0.62) and basal blood pressure (0.21) were both significantly associated with background stress, p's < 0.01. The importance of the proposed measure is reflected in the limited research base on the impact of background stress. Systematic investigation of this measure will provide insight into this understudied form of chronic stress and its potential influence on both psychological and physical endpoints. Copyright © 2013 John Wiley & Sons, Ltd.     

The Essential Resilience Scale: Instrument Development and Prediction of Perceived Health and Behaviour

Further advancement in stress and health research calls for better tools to assess resilience. In this study, we developed the Essential Resilience Scale (ERS) and investigated the association between ERS scores and several health and behaviour measures. We developed the ERS with an operationalized definition of resilience—an individual's capability to anticipate, be flexible with and bounce back from three types of traumatic and adverse events (physical, emotional and social). The 15‐item ERS was assessed using survey data from a diverse sample (n = 238, aged 18–45 years, 76 rural‐to‐urban migrants, 85 rural residents, 77 urban residents) recruited in Wuhan, China. Results showed a high reliability of the ERS (α = 0.94). Confirmatory factor analysis demonstrated a satisfactory fit of the proposed second‐order ERS measurement model (goodness‐of‐fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.06, chi‐square/df = 1.75). Multivariate regression analysis indicated that ERS scores significantly predicted perceived health status, stress, anxiety, depression and cigarette smoking after controlling for important covariates. Findings of this study indicate high reliability and validity of the scale and its potential use in advancing stress and health research. Further studies are implied to provide additional support for the ERS and its relations with other health outcomes. Copyright © 2015 John Wiley & Sons, Ltd.     

A Clinical Tool to Measure the Components of Health-Care Transition from Pediatric Care to Adult Care: The UNC TRxANSITION Scale

Objective: To describe the development of the University of North Carolina (UNC) TR_xANSITION Scale that measures the health-care transition and self-management skills by youth with chronic health conditions. Methods: Item and scale development of the UNC TR_xANSITION Scale was informed by two theoretical models, available literature, and expert opinion interviews and feedback from youth with chronic conditions, their parents, and interdisciplinary collaboration. Through an iterative process, three versions of the scale were piloted on a total of 185 adolescents and emerging adults with different chronic illnesses. This clinically administered scale relies on a semi-structured interview format of the patient and does not rely solely on patient report, but is verified with information from the medical record to validate responses. Results: Following the item development and the three iterations of the scale, version 3 was examined in a more intensive fashion. The current version of the UNC TR_xANSITION Scale comprises 33 items scattered across the following 10 domains: Type of illness, Rx=medications, Adherence, Nutrition, Self-management, Informed-reproduction, Trade/school, Insurance, Ongoing support, and New health providers. It requires approximately 7–8 min to administer. With a sample of 128 adolescents and young adults, ranging in age from 12 to 20, inter-rater reliability was strong (r = 0.71) and item-total correlation scores were moderate to high. Content and construct validity were satisfactory, and the overall score was sensitive to advancing age. The univariate linear regression yielded a beta coefficient of 1.08 (p < 0.0001), indicating that the total score increased with advancing age. Specifically, there was about a one point increase in the total score for each year of age. Conclusion: The UNC TR_xANSITION Scale is a disease-neutral tool that can be used in the clinical setting. Initial findings suggest that it is a reliable and valid tool that has the potential to measure health-care transition skill mastery and knowledge in a multidimensional fashion.     

Validation of the Dutch cystic fibrosis questionnaire (CFQ) in adolescents and adults.

BACKGROUND: This study assesses the reliability and validity of the Dutch version of a disease-specific measure of health-related quality of life (HRQOL) for adolescents and adults with CF (CFQ-14+). The 47-item CFQ-14+ covers nine domains, three symptom scales and one health perception scale. METHODS: To assess psychometric characteristics of the CFQ-14+, cross-sectional (homogeneity, discriminative and construct validity) and test-retest designs were used. Eighty-four adolescents and adults with CF (mean age: 21.4 years, range 14.0-46.5 years) and a wide range of lung function (mean FEV1: 59.9% predicted, range 15-121%) completed the questionnaire during a routine visit. RESULTS: Internal consistency was acceptable for most domains of the CFQ-14+ (alpha = 0.43-0.92) and test-retest reliability was high for all domain scores (0.72-0.98). Several domains of the CFQ-14+ were able to differentiate between individuals with varying disease severity and between nourished and malnourished patients. Construct validity of the questionnaire was fair, with moderate to strong correlation between physically orientated domains and pulmonary function (rs = 0.36-0.62). CONCLUSION: The results demonstrate that the CFQ-14+ questionnaire is a well-validated measure of HRQOL assessment in adolescents and adults with CF.     

痴呆恐惧量表的汉化及信效度检验

目的汉化痴呆恐惧量表,并在社区老年人中检验其信效度。方法根据Brislin翻译原则翻译痴呆恐惧量表,通过专家咨询和预试验进行文化调适,采用便利抽样法选取230名社区老年人进行问卷调查,检验中文版量表的信度和效度。结果中文版痴呆恐惧量表包含认知、社会和躯体3个维度,涉及痴呆症的体验与认识(7个条目)、担心家庭负担(4个条目)、羞耻感(3个条目)和躯体反应(4个条目)4个因子共18个条目。量表内容效度指数为0.934,各条目内容效度指数为0.857~1.000;探索性因子分析共提取4个公因子,累积方差贡献率为77.464%;总量表Cronbach′sα系数为0.893,重测信度为0.854。结论中文版痴呆恐惧量表在社区老年人中应用信效度较好,可用于老年人痴呆恐惧的识别和评估。